Symptom Clusters in Patients with HCC: A Systematic Review

Background HCC patients suffering from various symptoms during palliative care. Effective symptom management can reduce patient's painful symptom experience and improve their quality of life. The researches on symptom management have shifted from single symptom to multiple symptoms occurring simultaneously. Meanwhile, different studies varied considerably on the symptom clusters and its composition. Objectives The aim of this systematic review was to summarize the compositions, measures, and analytical techniques of symptom clusters in patients with HCC. Method We conducted a comprehensive search to identify published studies about symptom clusters in patients with HCC. Databases including National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journal Database (VIP), Wanfang Technology Journal full-text database, PubMed, EMbase and Web of Science and the studies included is from January 1, 2001 to November 24, 2019. Results There are seven articles compliance with inclusion criteria. Four symptom clusters were most commonly reported: Cluster 1: nausea/vomiting; Cluster 2: pain/fatigue/sleep disturbance/dry mouth/lack of appetite/change in taste; Cluster 3: sadness/distress/nervous; Cluster 4: jaundice/abdominal distension/itching/diarrhea/constipation. Conclusion This systematic review summarized the statistical methods, assessment tools, symptom clusterand composition of 7 included studies. Due to the lack of consensus on the definition of symptom cluster, the differences of statistical methods, assessment tools, sample characteristics and measuring time, the conclusion of the symptom cluster of HCC patients varied considerably in combinations.